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TENANCY APPLICATION – ONLINE FORM

Please complete all questions

PROPERTY APPLIED FOR:

HOW MANY APPLICANTS ARE THERE? 12

APPLICANT 1: PERSONAL INFORMATION

Forename(s):

Surname:

Previous Surname:

Date of Birth:

NI No:

Mobile No:

Other Tel No:

Email Address:

Current Address:

Time at current address:

APPLICANT 2: PERSONAL INFORMATION

Forename(s):

Surname:

Previous Surname:

Date of Birth:

NI No:

Mobile No:

Other Tel No:

Email Address:

Current Address:

Time at current address:

APPLICANT 1: ABOUT YOUR WORK

Name of Employer:

Contact Name:

Address of workplace:

Tel No:

Job Description:

Start Date in this employment:

Net Salary:

APPLICANT 2: ABOUT YOUR WORK

Name of Employer:

Contact Name:

Address of workplace:

Tel No:

Job Description:

Start Date in this employment:

Net Salary:

How Many Children/ Dependants Will Be Living With You?

DEPENDANT 1

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 1

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 2

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 1

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 2

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 3

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 1

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 2

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 3

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 4

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 1

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 2

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 3

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 4

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

DEPENDANT 5

Surname:
Forename(s):
M/F:MaleFemale
D.O.B.:
Relationship:

APPLICANT 1: WELFARE BENEFITS

Please Select All That Apply To You:JSAESADLA or PIPUCIncome SupportTax CreditsChild BenefitsOther

JSA:
ESA:
DLA or PIP:
UC:
Income Support:
Tax Credits:
Child Benefits:
Other:

Have you been convicted of a criminal offence?YesNo

Please Give Details:

Do You Have Any CCJ's?YesNo
Do You Smoke?YesNo
Do You Have Any Pets?YesNo

Please State:

APPLICANT 2: WELFARE BENEFITS

Please Select All That Apply To You:JSAESADLA or PIPUCIncome SupportTax CreditsChild BenefitsOther

JSA:
ESA:
DLA or PIP:
UC:
Income Support:
Tax Credits:
Child Benefits:
Other:

Have you been convicted of a criminal offence?YesNo

Please Give Details:

Do You Have Any CCJ's?YesNo
Do You Smoke?YesNo
Do You Have Any Pets?YesNo

Please State:

APPLICANT 1: CURRENT LANDLORD DETAILS

Landlord Name:

Address:

Tel No:

Start Date Of Tenancy:

Why Do You Wish To Move?

When do you wish to move?

Do you have any current rent arrears?YesNo

Have you ever had rent arrears?YesNo

Please Give Details:

Will you be claiming Housing Benefit?YesNo

APPLICANT 2: CURRENT LANDLORD DETAILS

Landlord Name:

Address:

Tel No:

Start Date Of Tenancy:

Why Do You Wish To Move?

When do you wish to move?

Do you have any current rent arrears?YesNo

Have you ever had rent arrears?YesNo

Please Give Details:

Will you be claiming Housing Benefit?YesNo

APPLICANT 1: PREVIOUS ADDRESSES

How Many Previous Addresses Do You Have?

Address 1

Previous Address 1:
Dates Lived There:
Landlord Name:
Contact Number:

Address 1

Previous Address 1:
Dates Lived There:
Landlord Name:
Contact Number:

Address 2

Previous Address 2:
Dates Lived There:
Landlord Name:
Contact Number:

Address 1

Previous Address 1:
Dates Lived There:
Landlord Name:
Contact Number:

Address 2

Previous Address 2:
Dates Lived There:
Landlord Name:
Contact Number:

Address 3

Previous Address 2:
Dates Lived There:
Landlord Name:
Contact Number:

APPLICANT 2: PREVIOUS ADDRESSES

How Many Previous Addresses Do You Have?

Address 1

Previous Address 1:
Dates Lived There:
Landlord Name:
Contact Number:

Address 1

Previous Address 1:
Dates Lived There:
Landlord Name:
Contact Number:

Address 2

Previous Address 2:
Dates Lived There:
Landlord Name:
Contact Number:

Address 1

Previous Address 1:
Dates Lived There:
Landlord Name:
Contact Number:

Address 2

Previous Address 2:
Dates Lived There:
Landlord Name:
Contact Number:

Address 3

Previous Address 2:
Dates Lived There:
Landlord Name:
Contact Number:

GUARANTOR DETAILS

Please provide details of your proposed guarantor. This will be someone who is prepared to pay your rent if you or your Benefit does not pay.
This should be a mature home owner or someone in a full time job.

Forename(s):
Surname:
Current Address:
Time at current address:
Date of Birth:
Mobile No:
Other Tel No:

Home Owner:YesNo
Employed:YesNo

Name of Employer:
Address of Employer:
Employer Tel No:
Job Description:
Time Employed:

Net Salary:


DECLARATION

I/we certify that the information given in this application is true.

I/we understand that Platinum Lettings Limited reserve the right to take action for possession of any accommodation if it has been obtained by providing false or misleading information, whether deliberately or recklessly.

I/we consent for Platinum Lettings Limited to obtain relevant information about me for the purposes of processing this application for Housing including a credit check.

I/We agree for any necessary enquiries being made by or on behalf of Platinum Lettings Limited in order to confirm the details given on this form.

I/We understand that the information provided on this form may be used to prevent and detect fraud.


Applicant 1

Signed:
Dated:

Applicant 2

Signed:
Dated: